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Welfare Plans Edition

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May 30, 2000

7th Cir: Insurer's Denial of Untimely Appeal of LTD Benefits Termination Did Not Violate ERISA
Excerpt: "An insurance company properly denied a beneficiary's appeal of the termination of her long term disability benefits because the appeal was filed more than 60 days after the insurer informed the beneficiary of the termination. This was the decision of the Seventh Circuit U.S. Court of Appeals in Gallegos v. Mt. Sinai Medical Center and UNUM Life Insurance Company of America." (Spencernet)

New HMO Fight: State Regulation of Medical Malpractice
Excerpt: "A doctor refuses a treatment for a sick child. State medical officials later find the treatment should have been provided, and that the doctor blundered. Should the doctor escape punishment because he works as a medical director for an HMO or other managed care company?" (New York Times; free registration required)

Lawsuit Puts California HMOs on Defensive
Excerpt: "California might want to consider adopting a new nickname: the HMO Lawsuit State. Yet another lawsuit has been filed against three leading health plans in the Golden State by the California Medical Association (CMA), fueling the growing tension between doctors and HMOs." (insure.com)

MEWAs Under ERISA: A Guide to Federal and State Regulation (PDF)
Seems to be a newly-published online item. The DOL site is quite slow, though, so you might have trouble downloading this PDF document. (U.S. Department of Labor)

Consumers Group Asks California Attorney General to Review HMO Mandatory Arbitration Rules
Excerpt: "FTCR is asking the Attorney General to investigate the practice of Blue Cross in disregarding the American Arbitration Association's (AAA) established health care rules of arbitration and instead forcing the arbitrator to use the 'commercial rules.'" (Foundation for Taxpayer and Consumer Rights)

Scant Progress Seen in Talks on Patients' Bill of Rights
Excerpt: "US congressional negotiators, facing an informal Memorial Day deadline, reported scant progress late last week in attempts to reach an agreement on a patients' rights bill, and some Democrats said that talks were virtually stalled." (Medscape; free registration required)

House Leaders Pull Bill to Let Doctors Bargain Collectively
Excerpt: "Facing fierce opposition from within their own ranks, House GOP leaders yesterday abruptly pulled from the floor a bill that would allow doctors to bargain collectively with insurance companies." (Washington Post)

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